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The Impact of Phaleria macrocarpa Fruit Flavonoid Extract on Endometrial Thickness in Mice Menopausal Model Wijaya, Dyah Ayu Septika; Dwi Wulandari, Recavery; Sutrisno, Sutrisno; Irwanto, Yahya; Anita, Kenty Wantri
Medical Laboratory Technology Journal Vol. 10 No. 1 (2024): June
Publisher : Poltekkes Kemenkes Banjarmasin Jurusan Analis Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/mltj.v10i1.584

This study aims to determine how the effect of flavonoid phaleria macrocarpa fruit extract on the endometrial thickness of Mus musculus which is used as an experimental animal with a menopause model. This study employed a randomized post-test-only control group design on 32 female mice. Ovariectomy simulated menopause, followed by treatment with flavonoid from Phaleria macrocarpa fruit extract. Post-observariectomized, follicle-stimulating hormone levels indicated menopausal status. Hematoxylin-Eosin methods assessed endometrial thickness. The result indicated reduced endometrial thinning in the positive control group (K+). Conversely, the treatment group (P1-P4) exhibited increased endometrial thickness post-flavonoid extract administration. Ovariectomized-induced estrogen decline resulted in reduced endometrial thinning, mimicking menopausal conditions. Statistically, flavonoid extract administration increased endometrial thickness in ovariectomized-induced menopausal mice, with optimal effect observed at 7.5 mg/mice/day for 14 days. The preferred intervention dose for altering endometrial thickness in menopausal conditions was identified as P1 (3.75 mg/mice/day). In conclusion, a flavonoid from Phaleria macrocarpa fruit extract mitigates endometrial thinning in the menopausal mice model. For implication in menopausal women, clinical trials need to be conducted to evaluate the dosage of these flavonoids for their potential as a natural SERM (Selective Estrogen Receptor Modulator) before clinical application in managing endometrial health. Additionally, research on molecular effects particularly regarding ER (Estrogen Receptors) in the endometrial organ, is needed to confirm their phytoestrogenic effect.

The Effect of Curcumin Administration on p53 and Caspase-3 Expression in Cervical Cancer HeLa Cell Culture Purba, Irene Silvia; Irwanto, Yahya; Rahardjo, Bambang; Handayani, Puspita
Asian Journal of Health Research Vol. 3 No. 3 (2024): Volume 3 No 3 (December) 2024
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v3i3.201

Introduction: Cervical cancer is a type of cancer with 605,000 new cases globally each year, with a mortality rate of 340,000. Curcuma longa, or curcumin, has the potential to enhance apoptosis in cervical cancer cells through the NF-kB-p53-caspase-3 pathway. Material and Methods: This in vitro experimental study employed a Completely Randomized Design (CRD) using HeLa cell cultures derived from cervical adenocarcinoma (ATCC® CCL2™). Cells were grown in Dulbecco's Modified Eagle Medium (DMEM) and treated with curcumin at concentrations of 25 µg/mL, 50 µg/mL, 100 µg/mL, 150 µg/mL, and 250 µg/mL. Cytotoxicity was assessed using the CCK-8 assay, apoptosis via flow cytometry, and p53 and caspase-3 expression using immunofluorescence. Statistical analysis was performed with IBM Statistics SPSS 25. Results: There was an increase in the percentage of apoptosis, p53 expression, and caspase-3 expression. At a dose of 100 µg/mL, total apoptosis increased significantly, reaching nearly 25% (p=0.000). P53 expression significantly increased at curcumin doses of 50 µg/mL and 100 µg/mL (p=0.021). There was a significant increase in caspase-3 expression, reaching approximately 86.2%, with a maximum effect at a dose of 100 µg/mL (p=0.002). Conclusion: Curcumin shows promising potential as an anticancer agent by reducing cell viability and enhancing apoptotic activity in HeLa cervical cancer cells.

Phaleria macrocarpa Fruit Flavonoid Extract on Estrogen Receptor Alpha Expression in Ovariectomized Mice Wijaya, Dyah Ayu Septika; Sutrisno, Sutrisno; Irwanto, Yahya; Anita, Kenty Wantri
Indonesian Journal of Human Nutrition Vol. 11 No. 1 (2024)
Publisher : Department of Nutrition, Faculty of Health Sciences, Universitas Brawijaya Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.ijhn.2024.011.01.10

Menopause signifies the cessation of ovarian function, presenting significant health challenges for women globally. Hormonal shifts during menopause impact various systems, including cardiovascular and reproductive health. Changes in reproductive organs increase susceptibility to health issues, necessitating effective management strategies. This study used a true experimental method with a randomized post-test-only control group design to investigate the potential of Phaleria macrocarpa fruit extract, which contains flavonoids, to modulate Estrogen Receptor Alpha (ERa) expression in menopausal mice. Following ovariectomy (OVX), mice treated with flavonoid showed increased ERa expression, with the highest expression observed at a dose of P2 (7.5 mg/mice/day), approaching those in non-OVX control (K-) with a percentage difference of 29.82%. Compared to the OVX control group (K+), the percentage increase was 2387.74%. Therefore, the P2 dose is considered the optimum dose. Regression analysis revealed a significant correlation of 43.3% between flavonoid dosage and ERa expression (p < 0.05). These findings suggest flavonoids as promising natural Selective Estrogen Receptor Modulators (SERMs) for managing menopausal symptoms and reducing endometrial disease risk with ERa modulation. Further research is needed to elucidate the mechanisms of flavonoids, including molecular pathways such as ligand binding and transcription, interactions with other hormones like progesterone, long-term effects, and potential clinical applications. To initiate clinical trials, the author established the P1 dose (3.75 mg/mice/day), which demonstrated expression levels approaching the effects produced by P2. Overall, flavonoids offer potential therapeutic benefits in addressing menopausal health concerns, with the identified optimal dosage providing valuable guidance for future studies and clinical interventions.

Phaleria macrocarpa Fruit Flavonoid Extract on Estrogen Receptor Alpha Expression in Ovariectomized Mice Wijaya, Dyah Ayu Septika; Sutrisno, Sutrisno; Irwanto, Yahya; Anita, Kenty Wantri
Indonesian Journal of Human Nutrition Vol. 11 No. 1 (2024)
Publisher : Department of Nutrition, Faculty of Health Sciences, Universitas Brawijaya Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.ijhn.2024.011.01.10

Menopause signifies the cessation of ovarian function, presenting significant health challenges for women globally. Hormonal shifts during menopause impact various systems, including cardiovascular and reproductive health. Changes in reproductive organs increase susceptibility to health issues, necessitating effective management strategies. This study used a true experimental method with a randomized post-test-only control group design to investigate the potential of Phaleria macrocarpa fruit extract, which contains flavonoids, to modulate Estrogen Receptor Alpha (ERa) expression in menopausal mice. Following ovariectomy (OVX), mice treated with flavonoid showed increased ERa expression, with the highest expression observed at a dose of P2 (7.5 mg/mice/day), approaching those in non-OVX control (K-) with a percentage difference of 29.82%. Compared to the OVX control group (K+), the percentage increase was 2387.74%. Therefore, the P2 dose is considered the optimum dose. Regression analysis revealed a significant correlation of 43.3% between flavonoid dosage and ERa expression (p < 0.05). These findings suggest flavonoids as promising natural Selective Estrogen Receptor Modulators (SERMs) for managing menopausal symptoms and reducing endometrial disease risk with ERa modulation. Further research is needed to elucidate the mechanisms of flavonoids, including molecular pathways such as ligand binding and transcription, interactions with other hormones like progesterone, long-term effects, and potential clinical applications. To initiate clinical trials, the author established the P1 dose (3.75 mg/mice/day), which demonstrated expression levels approaching the effects produced by P2. Overall, flavonoids offer potential therapeutic benefits in addressing menopausal health concerns, with the identified optimal dosage providing valuable guidance for future studies and clinical interventions.

Hubungan Antara Akses Informasi Dan Dukungan Petugas Kesehatan Dengan Keikutsertaan Wanita Usia Subur (WUS) Dalam Deteksi Dini Kanker Serviks Metode Inspeksi Visual Asam Asetat (IVA) Di Desa Klampok Wilayah Kerja Puskesmas Singosari Khasanah, Wasingatin Catur; Fatmawati, Fatmawati; Irwanto, Yahya
Journal of Issues in Midwifery Vol. 9 No. 2 (2025): Volume 9 No 2 Tahun 2025
Publisher : Journal of Issues in Midwifery

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.JOIM.2025.009.02.3

ABSTRAK Kanker serviks masih jadi masalah kesehatan global sebanyak 604.127 kasus kanker serviks baru di berbagai belahan dunia. Di Indonesia, kanker serviks menempati urutan kedua dalam jenis kanker yang paling umum, terutama dipicu oleh Human Papilloma Virus (HPV) yang ditularkan melalui aktivitas seksual. Pemeriksaan Inspeksi Visual dengan Asam Asetat (IVA) telah menjadi metode penting untuk deteksi dini lesi pra kanker serviks pada wanita usia subur (WUS). Penelitian ini bertujuan menetapkan hubungan antara akses informasi dan dukungan medis dengan partisipasi WUS dalam pemeriksaan IVA di Desa Klampok, Singosari, Malang. Kesimpulan: terdapat hubungan signifikan antara faktor-faktor tersebut dan keikutsertaan WUS dalam IVA di Desa Klampok. Kata kunci: IVA, Kanker Serviks, Akses Informasi, Dukungan Petugas Kesehatan ABSTRACT Cervical cancer is still a global health problem with 604,127 new cases of cervical cancer in various parts of the world. In Indonesia, cervical cancer ranks second in the most common type of cancer, mainly triggered by the Human Papilloma Virus (HPV) which is transmitted through sexual activity. Visual Inspection with Acetic Acid (IVA) has become an important method for early detection of pre-cancerous cervical lesions in women of childbearing age (WUS). This study aims to determine the relationship between access to information and medical support with WUS participation in IVA examination in Klampok Village, Singosari, Malang. Conclusion: there is a significant relationship between these factors and WUS participation in IVA in Klampok Village. Keywords: IVA, Cervical Cancer, Access to Information, Support from Healthcare Professsional

Emergency Pregnancy with Severe Preeclampsia and Total Atrioventricular Block In A 28-Year-Old Woman Cholili, Muhamad Nofa; Irwanto, Yahya
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 9 No 01 (2025): Qanun Medika Vol 09 No 01 January 2025
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v9i01.22296

The co-occurrence of preeclampsia with bradycardia due to total atrioventricular block (TAVB) during pregnancy is a rare yet severe phenomenon. There is limited literature available on this specific combination. This case report aims to contribute valuable insights by documenting the clinical presentation and management of a 28-year-old woman who is diagnosed with severe preeclampsia and total atrioventricular block during pregnancy. A 28-year-old pregnant woman was referred to the emergency room with dyspnea and vaginal discharge. She had a history of cardiac issues, including atrial septal defect and total atrioventricular block. Her blood pressure was 206/129 mmHg, and a pulse rate of 67 beats per minute. Then, she was diagnosed with severe preeclampsia, hypertensive emergency, and impending eclampsia with a suspect congenital disease contributing to her atrioventricular block. The patient underwent urgent cesarean section intrauterine stabilization and received postoperative care. Postoperatively, the patient reported no further dyspnea or bradycardia. The history of salbutamol usage and the activation of plasminogen activator inhibitor-1 (PAI-1) in patients with atrial septal defects (ASD) is suspected as a potential etiological factor in the pathophysiology of preeclampsia during pregnancy. TAVB can be induced by congenital ASD. In conclusion, the use of salbutamol and activation of PAI-1 in patients with TAVB induced by ASD are suspected as potential causes of preeclampsia during pregnancy.

The Effect Flavonoids Phaleria macrocarpa Fruit Extract on Thickness of Trabeculae, Cortex Ratio Femoral Bone and Aortic Intima-Media in Mice Menopause Model Fadilah, R. A. Rahmawati Nurul; Khoirinda, Ani; Sutrisno, Sutrisno; Irwanto, Yahya; Anita, Kenty Wantri; Dewi, R. A. Rose Khasana
JURNAL INFO KESEHATAN Vol 22 No 2 (2024): JURNAL INFO KESEHATAN
Publisher : Research and Community Service Unit, Poltekkes Kemenkes Kupang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31965/infokes.Vol22.Iss2.1553

A deficiency of the hormone estrogen at menopause can lead to an increased rate of the destruction of the bone tissue that leads to bone loss, which can lead to osteoporosis and impaired fat metabolism, which increases the risk of atherosclerosis. Phytoestrogens from flavonoid extract P. Macrocarpa, having effects similar to endogenous estrogens themselves, prevent osteoporosis and atherosclerosis in menopausal women. The purpose of this research is to assess the influence of flavonoids from P. Macrocarpa fruit extract on trabeculae cortex thickness, ratio of femoral bone, and aortic IMT (A-IMT) in a menopausal mouse model. The study was conducted in a true experimental-posttest-only control group design. Using 32 mice; namely KN (normal mice with no treatment), KP (OVX with no treatment), P1(OVX and given flavonoid 3.75 mg/mice/day), P2 (OVX and given flavonoid 7.5 mg/mice/day), P3(OVX and given flavonoid 11.25 mg/mice/day), P4 (OVX and given flavonoid 15 mg/mice/day), the treatment given within 14 days. Then the thickness of the trabeculae, cortex, and intima-media aorta with Hematoxylin-Eosin (HE) staining. In the trabeculae, cortex thickness ratio obtained KN results meaningfully dissimilar to the KP group and the P3 and P4 groups were meaningfully dissimilar from the KP. The A-BMI in KP is meaningfully dissimilar to P1, P2, P3 and P4. The conclusion of the study is flavonoid fruit extract P. Macrocarpa can increase the thickness ratio of trabeculae, and cortex femoral bone of mice menopausal model in groups P3, P4 and can decrease A-IMT starting in groups P1 to P4.

The Effect of Flavonoids of Phaleria macrocarpa Fruit Extract on Aortic Diameter Mice Menopause Model Khoirinda, Ani; Fadilah, R. A. Rahmawati Nurul; Sutrisno, Sutrisno; Irwanto, Yahya; Dewi, R. A. Rose Khasana
JURNAL INFO KESEHATAN Vol 22 No 2 (2024): JURNAL INFO KESEHATAN
Publisher : Research and Community Service Unit, Poltekkes Kemenkes Kupang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31965/infokes.Vol22.Iss2.1554

Menopause is a phase experienced by women with an age range of 45-55 years. Menopause is a condition where menstruation stops for a minimum of 12 consecutive months due to the decline in ovarian function, leading to a reduction in estrogen levels. A decrease in estrogen can lead to impaired fat metabolism resulting in atherosclerosis. This study aimed to illustrate the influence of flavonoid extract derived from Phaleria Macrocarpa on the enlargement of the aorta's diameter of mice with a menopause condition. The method of this study is a genuine experimental laboratory setting with a research design of a Randomized Post Test Only Control Group setting. Using 32 female mice divided into 6 groups: K- (without ovariectomy and flavonoid extract Phaleria Macrocarpa), K + (ovariectomy without treatment), P1 (ovariectomy + dose 3.75 mg/mice/day), P2 (ovariectomy + dose 7.5 mg/mice/day), P3 (ovariectomy + dose 11.25 mg/mice/day), and P4 (ovariectomy + dose 15 mg/mice/day). Administration of flavonoid extract Phaleria Macrocarpa was carried out for 14 days. Data analysis using statistical analysis. The results showed that in a post-hoc test, namely the administration of Phaleria macrocarpa flavonoid extract at a dose of 11.25 mg/mice/day and 15 mg/mice/day showed that it could increase the dilation of the aortic diameter of mice model menopause. The study concludes that the flavonoid fruit extract from Phaleria Macrocarpa has the ability to increase the width of the aorta in mice with a menopause condition. In future studies, it is recommended to investigate various variables in order to identify the factors that contribute to the narrowing of the aorta. Additionally, it is suggested to perform further research specifically focusing on women going through menopause.

Neoadjuvant Chemotherapy Before Radical Hysterectomy in Cervical Cancer: A Systematic Comparison of Robotic vs Abdominal Approaches Wahyuni, Rizki; Irwanto, Yahya
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.248

Introduction: Cervical cancer remains a leading cause of cancer mortality worldwide. Neoadjuvant chemotherapy (NACT) followed by radical hysterectomy (RH) is increasingly used, but the comparative safety and efficacy of robotic‐assisted versus open abdominal RH after NACT remain unclear. Material and Methods: This PRISMA‐compliant systematic review (January 2015–March 2025) analyzed randomized and observational studies comparing robotic‐assisted RH (RRH) and open RH (ARH) in women with FIGO IB₂–IIA₂ cervical cancer treated with platinum‐based NACT. The primary endpoints were intraoperative and postoperative complications. Seven studies involving 534 patients (284 minimally invasive vs. 250 open) met the inclusion criteria. Results: Overall complication rates were similar between groups (15–20%). Minimally invasive surgery (MIS) significantly reduced estimated blood loss by 75–315 mL (p<0.05) and shortened hospital stay by 1–2 days (p<0.01). Operative time was comparable, with minor increases in conventional laparoscopy. In nerve‐sparing procedures, MIS provided faster bladder and bowel recovery (post‐void residual normalization 11 vs. 18 days; time to flatus 39 vs. 56 hours; p<0.01) and improved 1‐year urinary and intestinal quality of life. Conclusion: Six of seven studies found no difference in disease‐free or overall survival between MIS and open RH. One study reported worse outcomes with RRH among patients with FIGO IIB disease and multi‐agent NACT (HR 2.5–3.0; p<0.05), suggesting risk in higher‐stage, heavily pretreated cases. Overall, robotic‐assisted RH appears to be a safe and effective alternative to open surgery for appropriately selected FIGO IB₂–IIA₂ cervical cancer patients after NACT.

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